MOOSE DENSITY, HABITAT, AND WINTER TICK EPIZOOTICS IN A CHANGING CLIMATE

Unregulated hunting and habitat loss led to a near extirpation of moose (Alces alces) in New Hampshire in the 1800s. After state protection in 1901, the estimated population increased slowly to ~500 moose in 1977, then increased rapidly in the next 2 decades to ~7500 following an increase in browse habitat created by spruce budworm (Choristoneura fumiferana) and related timber salvage operations, and then halved from 1998-2016 despite highly available optimal habitat. The declining population was partially related to the specific management objective to reduce moose-vehicle collisions, and a possible change in deer hunter and moose behavior that influence population estimates. But given the substantial decline in productivity and condition of cows, and frequent episodes of high calf mortality in April, the primary cause of decline was presumed to be is an increase in winter tick abundance. This study examined the relationships among moose density, optimal habitat, weather/ground conditions, winter tick abundance, and natal dispersal in northern New England. Comparing movement data from the previous (2002-2006) and current (2014-2016) productivity studies in New Hampshire and Maine, the distance of natal dispersal, home and core range size, and home and core range overlap did not significantly (P \u3e 0.05) change despite an increase in optimal habitat and a decrease in moose density. Geographic changes in tick abundance were related to an interaction between moose density, and the onset and length of winter. Annual changes in tick abundance in northern New Hampshire are driven by desiccating late summer conditions, as well as the length of the fall questing season. Lower precipitation (6.4 cm) and higher minimum temperatures (9.8 °C) specifically concentrated during larval quiescence from mid-August through mid-September reduces winter tick abundance and the likelihood of an epizootic event. The onset of winter, defined by the first snowfall event (\u3e 2.54 cm), influenced the length of the questing season relative to the date of long-term first snowfall event (14 November). In the epizootic region, average winter tick abundance on moose harvested in mid-October indicated a threshold of 36.9 ticks, above which an epizootic is like to occur unless an early snowfall event shortened the fall questing season. Optimal habitat created by forest harvesting was produced at an annual rate of 1.3% (1999-2011) and is not considered limiting in northern New Hampshire, but likely concentrates moose density locally (~4 moose/km2) facilitating the exchange of winter ticks. In northern New Hampshire, snow cover late into April did not reduce tick abundance in the following year and cold temperatures (\u3c 17 °C) that induced replete adult female mortality are extremely rare in April. Given a continuation of warming climate and conservative moose harvest weather conditions and high local moose densities will continue to favor the life cycle of winter ticks, increasing the frequency of winter tick epizootics and shift the epizootic region slowly northward. Conversely, temporary reduction of moose density may substantially reduce parasite abundance and support a healthier and more productive moose population

Health Inequalities in British Nurses using Census derived databases linked to an adjusted UK Index of Multiple Deprivation

Introduction Scottish health outcomes are worse than in England and Wales. This variation remains after controlling for deprivation, which explains less excess mortality now than previously. Alternative cross-national deprivation measures have limitations which may explain some of this trend. Recent policy interventions to reduce inequalities have not been effective. Objectives and Approach This study aims to test a recently developed measure of area deprivation, the UK adjusted Index of Multiple Deprivation which has been linked to National Census derived Longitudinal Studies in England, Wales and Scotland. This adjusted measure is consistent across UK countries and addresses some limitations of previously utilised area measures of deprivation. This study also aims to test whether characteristics of Nurses are protective against inequalities in health. This study will test whether Nurses are more socio-economically homogenous and whether higher health literacy is protective against the social gradient in health outcomes. Results (1) Comparing Nurses to Non-Nurses in Scotland we found that they have systematically different demographic characteristics. Nurses are; older on average, more likely to be female, more likely to own their home, more likely to live in less deprived areas and they report better self-rated health. (1a) Correlation tests will examine the strength of relationship between health and Deprivation quintile for these groups. (2) Comparing Self-Rated Health of Scottish Nurses with English and Welsh Nurses will determine whether any ‘excess’ in worse health outcomes exists and (2a) if an excess does exist, whether the UK consistent deprivation measure can account for this. Analysis is currently ongoing and will be completed, with full results cleared for dissemination through disclosure control, prior to conference. Conclusion/Implications This study implements methods which provide a basis for cross-national comparison of inequalities using individual-level data and a consistent measure of area deprivation. Results from this study may also permit recommendations to improve the effectiveness of policy aimed at improving population health and reducing socio-economic inequalities in health

Health Inequalities in the British Nursing Workforce

Background Average health in the UK is improving, yet geographical inequalities in health persist. The relative difference between the least and most deprived is also growing. Recent policy interventions to reduce these inequalities have not been effective. Methods This work compares Self-Rated Health using the ONS LS and SLS linked to an adjusted UK-consistent small-area Deprivation measure. This study aims to compare Nurses to the general population to assess whether they also exhibit a social gradient in health. Using a single occupational group adjusts for potential confounders and tests whether characteristics of Nurses, such a good health literacy, degree education and above average income, are protective against inequalities. Results In Scotland, Nurses are more likely to be older, female, homeowners who live in less deprived areas with better Self-Rated Health than Non-Nurses. We will test whether the social gradient in health is observed for this occupational group. Forthcoming results from cross-national analysis will be presented at conference following disclosure checks. Conclusion The relationship between area deprivation and health may remain even in relatively privileged groups. Results from this study may inform recommendations to improve the effectiveness of policy aimed at improving population health and reducing socio-economic inequalities in healt

(De)marketing to Manage Consumer Quality Inferences

Savvy consumers attribute a product’s market performance to its intrinsic quality as well as the seller’s marketing push. The authors study how sellers should optimize their marketing decisions in response. They find that a seller can benefit from “demarketing” its product, meaning visibly toning down its marketing efforts. Demarketing lowers expected sales ex ante but improves product quality image ex post, as consumers attribute good sales to superior quality and lackluster sales to insufficient marketing. The authors derive conditions under which demarketing can be a recommendable business strategy. A series of experiments confirm these prediction

Ultrasensitive detection of lipoarabinomannan with plasmonic grating biosensors in clinical samples of HIV negative patients with tuberculosis.

BACKGROUND:Timely diagnosis of tuberculosis disease is critical for positive patient outcomes, yet potentially millions go undiagnosed or unreported each year. Sputum is widely used as the testing input, but limited by its complexity, heterogeneity, and sourcing problems. Finding methods to interrogate noninvasive, non-sputum clinical specimens is indispensable to improving access to tuberculosis diagnosis and care. In this work, economical plasmonic gratings were used to analyze tuberculosis biomarker lipoarabinomannan (LAM) from clinical urine samples by single molecule fluorescence assay (FLISA) and compared with gold standard sputum GeneXpert MTB/ RIF, culture, and reference ELISA testing results. METHODS AND FINDINGS:In this study, twenty sputum and urine sample sets were selected retrospectively from a repository of HIV-negative patient samples collected before initiation of anti-tuberculosis therapy. GeneXpert MTB/RIF and culture testing of patient sputum confirmed the presence or absence of pulmonary tuberculosis while all patient urines were reference ELISA LAM-negative. Plasmonic gratings produced by low-cost soft lithography were bound with anti-LAM capture antibody, incubated with patient urine samples, and biotinylated detection antibody. Fluorescently labeled streptavidin revealed single molecule emission by epifluorescence microscope. Using a 1 fg/mL baseline for limit of detection, single molecule FLISA demonstrated good qualitative agreement with gold standard tests on 19 of 20 patients, including accurately predicting the gold-standard-negative patients, while one gold-standard-positive patient produced no observable LAM in urine. CONCLUSIONS:Single molecule FLISA by plasmonic grating demonstrated the ability to quantify tuberculosis LAM from complex urine samples of patients from a high endemic setting with negligible interference from the complex media itself. Moreover, agreement with patient diagnoses by gold standard testing suggests that single molecule FLISA could be used as a highly sensitive test to diagnose tuberculosis noninvasively

Clinical Educator and Student Perceptions of iPad™ Technology to Enhance Clinical Supervision: The Electronically-Facilitated Feedback Initiative (EFFI)

Purpose: Growing demands placed upon healthcare systems require more health professionals to be trained. Clinical placement education is an integral component of health professional training, however accommodating increasing numbers of student placements is a challenge for health services. Personal digital assistants such as iPads™ may assist in delivery of clinical education, by facilitating transfer of knowledge and skills from clinical educators to health professional students, however such an initiative has not been formally investigated. The present study sought to explore perceptions of clinical educators and allied health students regarding the impact of an iPad™-based feedback delivery system on student reflection and learning. Methods: A pilot study was performed using iPads™ with specialised software to deliver electronic formative feedback to physiotherapy, occupational therapy and speech pathology students during clinical placements. Students and clinical educators completed a questionnaire exploring advantages and disadvantages of the technology. Results: Nine clinical educators and 14 students participated and completed the survey. Clinical educators largely (n=7, 78%) reported the electronic feedback system was easy to use and 67% (n=6) reported it improved the quality of feedback provided to students. Five (56%) clinical educators thought electronic feedback improved student performance. Most students (n=10, 71%) reported electronic feedback facilitated reflection upon performance, and 64% (n=9) reported improved performance as a result. Disadvantages included poor wireless internet access and software inefficiencies (n=7 [78%] clinical educators, n=7 [50%] students), and difficulties using iPads™ in settings requiring infection control (n=2 [22%] clinical educators). Conclusions: Clinical educators and students perceived electronic feedback as a positive adjunct to student learning on clinical placement, however technological and software interface factors need to be considered for implementation in some settings

Study protocol for a randomised controlled trial of invasive versus conservative management of primary spontaneous pneumothorax

INTRODUCTION: Current management of primary spontaneous pneumothorax (PSP) is variable, with little evidence from randomised controlled trials to guide treatment. Guidelines emphasise intervention in many patients, which involves chest drain insertion, hospital admission and occasionally surgery. However, there is evidence that conservative management may be effective and safe, and it may also reduce the risk of recurrence. Significant questions remain regarding the optimal initial approach to the management of PSP

Empirical regularities of opening call auction in Chinese stock market

We study the statistical regularities of opening call auction using the ultra-high-frequency data of 22 liquid stocks traded on the Shenzhen Stock Exchange in 2003. The distribution of the relative price, defined as the relative difference between the order price in opening call auction and the closing price of last trading day, is asymmetric and that the distribution displays a sharp peak at zero relative price and a relatively wide peak at negative relative price. The detrended fluctuation analysis (DFA) method is adopted to investigate the long-term memory of relative order prices. We further study the statistical regularities of order sizes in opening call auction, and observe a phenomenon of number preference, known as order size clustering. The probability density function (PDF) of order sizes could be well fitted by a $q$-Gamma function, and the long-term memory also exists in order sizes. In addition, both the average volume and the average number of orders decrease exponentially with the price level away from the best bid or ask price level in the limit-order book (LOB) established immediately after the opening call auction, and a price clustering phenomenon is observed.Comment: 11 pages, 6 figures, 3 table